Medical Board Disciplines Three Minneapolis Providers

The Minnesota Board of Medical Practice disciplined two Minneapolis health care providers following a board meeting earlier this month, the agency announced Wednesday.

Ali Ebrahimi

Ali Ebrahimi, a psychiatrist who practices with Associated Clinic of Psychology in Brooklyn Center and Minneapolis, offers psychiatric evaluations and medication management, according to his biography.

The board received a complaint in July 2011 that Ebrahimi inappropriately prescribed drugs to a patient with a history of alcohol and chemical abuse, according to the stipulation and order. The complaint accused him of prescribing medicine for the patient’s chronic pain without recognizing the patient’s behaviors.

An investigation by the Attorney General’s Office found several cases in which Ebrahimi authorized “excessive quantities of controlled substances” based on patients’ claims of pain or other symptoms. In those cases, he failed to document objective clinical reasons for why the medicine was needed and an overall health plan, as well as failing to address collateral health concerns.

He also failed to monitor the efficacy of the medicine, monitor patients’ compliance, conduct pill counts, listen to warnings from other health care providers and recognize his patients’ drug-seeking behaviors.

In addition, he didn’t maintain adequate records. Investigators found at least 41 occasions when he prescribed a medication without documenting it in the clinic record.

The board found Ebrahimi guilty of “unethical and unprofessional conduct; improper management of medical records; inappropriate prescribing practices.”

It added the following conditions to Ebrahimi’s license:

“He is reprimanded;

“He shall read the Model Policy for pain control published by the Federation of State Medical Boards and Responsible Opioid Prescribing, A Clinician's Guide, 2nd Edition, by Scott M. Fishman, M.D.;

“He shall complete, within one year, the following pre-approved courses: Chemical dependency awareness, Boundaries.

“Six months following successful completion of the pre-approved courses, he shall undergo an audit of his prescribing practices;

“Before prescribing a Schedule II-IV drug, he shall check the Minnesota Prescription Monitoring Program;

“He shall develop, and submit for Committee approval, a written protocol for the management and tracking of controlled substance prescriptions;

“He shall develop, and submit for Committee approval, a narcotics agreement to be used with all chronic pain patients;

“He shall pay a civil penalty of $6575.60;

“This Stipulation and Order will remain in effect for a minimum of one year.  At the end of this period, he may petition for reinstatement of an unconditional license.  Upon hearing the petition, the Board may continue, modify or remove the conditions set out herein.

Steven G. Muehlstedt

Steven G. Muehlstedt’s license record lists his practice location as Pediatric Surgical Associates, although the company does not list him as one of its physicians. He is board certified in general surgery, with a subspecialty in pediatric surgery.

The Board of Medical Malpractice received a complaint in June 2012 that Muehlstedt was responsible for “many narcotic prescription irregularities,” according to a stipulation and order.

An investigation by the Attorney General’s Office found that on multiple occasions in 2011 and 2012 he wrote prescriptions in the names of family members but used the drugs himself.

On at least one occasion in 2012, he diverted pain medication from a pediatric patient who was being discharged from the hospital following surgery. He offered to drop off the prescription at the hospital pharmacy and pick it up for the family. However, he removed about 30 pills from the bottle before giving the remaining 120 pills to the family.

On July 9, 2012, he reported himself to the Health Professionals Services Program for evaluation of an addiction to prescription opiates and amphetamines. He entered into a plan to monitor his recovery about a month later and did not practice medicine in order to focus on his recovery.

The board found Muehlstedt guilty of “violating a federal law related to the practice of medicine; unethical conduct; unprofessional conduct, inability to practice medicine with reasonable skill and safety due to illness; becoming addicted to a drug or intoxicant; improper prescribing practices.”

It suspended his license but stayed the suspension on the following conditions:

“He is reprimanded.

“He shall participate in the Health Professionals Services Program (HPSP) and comply with all terms and conditions of his HPSP Participation Agreement and Monitoring Plan, including any modifications.  Failure to comply with the HPSP Monitoring Plan shall constitute a violation of this Order.

“He shall not prescribe, administer, or dispense any prescription drug or drug sample for his own use, his family members’ use, or for any person who is not in an established physician/patient relationship with him.

“He shall not prescribe Schedule II, Schedule III, and Schedule IV controlled substances without a co-signature.

“He shall obtain a pre-approved supervising physician who shall submit quarterly reports to the Board.

“He may petition for reinstatement of an unconditional license upon submission of satisfactory evidence of four years of documented, uninterrupted recovery, and upon successful completion of the terms of this Order.”